Primary Care Education iCME Podcast

Program Overview: Rates of death from cardiovascular and cerebrovascular diseases have been steadily declining over the past few decades. In spite of these declines, atherothrombotic disease continues to be a worldwide challenge in terms of morbidity, premature death, and disability with tremendous costs to patients, healthcare systems, and society. Cardiovascular disease (CVD) claims more lives each year than cancer, chronic lower respiratory disease, and accidents combined. In the United States alone, CVD and stroke remain the number 1 and number 3 killers of both men and women of all races and ethnicity. Nearly 2300 Americans die of CVD each day, an average of 1 death every 38 seconds. The primary care clinician plays a critical role in early diagnosis and detection of atherothrombosis, since the earliest signs and symptoms are often subtle and appear many years before its full-blown manifestation. Both primary and secondary prevention strategies include long term risk factor modification. For either primary or secondary prevention to be effective, provider/patient communication leading to good adherence to medication and lifestyle modifications is absolutely essential. Atherothrombosis and the heightened risk of recurrence represent major challenges to the clinician. Although vascular specialists often treat these patients acutely, the primary care setting is crucial in continuing lifestyle changes, effective drug therapy, and implementing treatment guidelines that have been initiated. Therefore, primary care clinicians must be comfortable and conversant with all current recommendations and guidelines, understand the most effective implementation techniques to use with their patients, and be familiar with resources available to assist in tackling this epidemic of CVD in their practices. This case-based, interactive lecture will demonstrate both knowledge and implementation of comprehensive risk reduction strategies and the AHA/ACC/ASA Guidelines for treating patients with atherothrombotic disease, with an emphasis on antiplatelet therapies. Learning Objectives: After completing this activity, the participant will be able to 1. Identify traditional and emerging risk factors that may aid in identifying patients at risk and with sub-clinical CVD 2. Implement the AHA/ACC Guidelines for oral antiplatelet therapy in patients with all forms of ACS (UA, NSTEMI, STEMI, and PCI) Accreditation/Designation Statement: Primary Care Network is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with Atherothrombosis. Release Date: August 2, 2010 Expiration Date: August 2, 2011 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Philadelphia, Pennsylvania on June 18, 2010 and is funded by Bristol-Myers Squibb/Sanofi Pharmaceutical Partnership.

Program Overview: Sleep disorders are common in all sections of the population and are either the main clinical complaint or a frequent complication of many conditions. Sleep-wake disorders alone affect 21% of the adult population. The responsibility of identifying and managing these patients is often up to the primary care clinician. While effective and efficient tools for screening and recognition of the various presentations of sleep disorders, including sleep-wake disorders, are available, primary care clinicians characterize their knowledge as poor to fair, lacking the awareness and the confidence to properly diagnose and effectively treat these disorders. To more optimally manage patients with sleep-wake disorders, this activity will provide information that is needed to differentiate between common symptoms of disorders occurring comorbid with sleep-wake disturbances and those in which sleep-wake disturbances are primary. The overarching focus of this session is identifying the diagnosis and treatment modalities for excessive daytime sleepiness (EDS). This will consist of discussion related to normal sleep hygiene and consequences of sleep-wake disturbances; insomnia, primary and secondary inclusive of medical and psychiatric comorbidity; and review of confounding diagnoses, including obstructive sleep apnea, restless leg syndrome, and narcolepsy. Through facilitated didactic and case-based learning new confidence will emerge when learning about integrating patient assessment tools and sleep scales into clinical practice, treating patients, and how best to develop strategies to optimize outcomes for patients with sleep-wake disorders. Learning Objectives: After completing this activity, the participant will be able to 1. Integrate the use of screening tools to differentiate primary versus secondary sleep disorders 2. Identify the treatment strategies based on individual patient factors and characteristics Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with sleep disorders. Release Date: November 19, 2009 Expiration Date: November 19, 2010 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Dallas, Texas, on October 23, 2009, and is funded by Cephalon, Inc.

Program Overview: Insomnia is the most common adult sleep complaint, affecting millions of people in the US, including up to 69% of primary care patients. However, even though it is a common disorder with considerable negative impact, it is underrecognized and many patients remain undiagnosed and untreated. Nationally known medical experts will discuss sleep physiology and sleep architecture, insomnia, insomnia prevalence and pathology, and the consequences of disrupted slow-wave sleep. Risk factors and the metabolic and cognitive consequences of insomnia will also be addressed while emphasizing current and emerging pharmacological and nonpharmacological therapies used in the treatment of insomnia. This educational activity will provide you with case-based examples to illustrate key issues in the management of the patient with insomnia in primary care. Learning Objectives: After completing this activity, the participant will be able to * Identify the underlying causes and comorbid conditions of insomnia for increased confidence in treatment * Assess the current and developing nonpharmacological and pharmacological approaches to the management of primary and comorbid insomnia Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with insomnia. Release Date: September 30, 2009 Expiration Date: September 30, 2010 Medium: Podcast Acknowledgement of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Baltimore, Maryland, on April 3, 2009, which was funded by sanofi-aventis US, LLC.

Program Overview: Type 2 diabetes is a significant and growing concern for primary care clinicians, with significant associated complications, including CVD, peripheral neuropathy, nephropathy, and blindness. In patients with diabetes, appropriate treatment will slow progression, and therefore development of complications, making management with an appropriate regimen and lifestyle changes critical for long-term patient outcomes. This activity will combine a real-world example of diagnosis and disease progression with the latest data on treatment safety and efficacy to enable clinicians to develop the best protocol for each patient. Learning Objectives: After completing this activity, the participant will be able to 1. Identify strategies for the treatment of the diabetic patient with obesity including therapeutic strategies and surgical interventions 2. Devise a strategy for the use of insulin in the primary care practice, including short-acting and long-acting analogues, combination therapy, and delivery devices Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with diabetes. Release Date: September 30, 2009 Expiration Date: September 30, 2010 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Las Vegas, Nevada, on April 25, 2009, which was funded by AstraZeneca/Bristol-Myers Squibb Alliance and The Amylin-Lilly Alliance.

Program Overview: Type 2 diabetes is a significant and growing concern for primary care clinicians, with significant associated complications, including CVD, peripheral neuropathy, nephropathy, and blindness. In patients with diabetes, appropriate treatment will slow progression, and therefore development of complications, making management with an appropriate regimen and lifestyle changes critical for long-term patient outcomes. This activity will combine a real-world example of diagnosis and disease progression with the latest data on treatment safety and efficacy to enable clinicians to develop the best protocol for each patient. Learning Objectives: After completing this activity, the participant will be able to 1. Identify treatment strategies for insulin use, based on patient outcomes and goal achievement 2. Identify the key mechanisms of incretin biology and incorporate appropriate treatment strategies to address glucose control Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with diabetes. Release Date: September 30, 2009 Expiration Date: September 30, 2010 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Las Vegas, Nevada, on April 25, 2009, which was funded by AstraZeneca/Bristol-Myers Squibb Alliance and The Amylin-Lilly Alliance.

Program Overview: Diabetes is a condition that affects a growing number of people—by the year 2010, an estimated 10% of the US population will be affected, and over 90% of this group will have type 2 diabetes. Effective long-term treatment interventions, as well as clinical tools to monitor disease progression and the impact of treatment, are being developed and used as part of the initiative to slow or halt the progression of type 2 diabetes and the development of complications. Although the majority of diabetes care is provided in the primary care setting, data indicate that approximately 50% of patients with type 2 diabetes do not achieve established targets of glycemic control despite receiving treatment for hyperglycemia. As such, it is important for healthcare providers who care for patients with type 2 diabetes, including primary care physicians, nurse practitioners, and certified diabetes educators, to recognize the symptoms of diabetes and to provide lifestyle interventions and medical treatments that fit into current treatment guidelines. Learning Objectives: After completing this activity, the participant will be able to 1. Identify the A1C goals for newly diagnosed diabetic patient and treatment strategies for when goals are not being met. Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with diabetes. Release Date: September 30, 2009 Expiration Date: September 30, 2010 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Atlanta, Georgia, on June 27, 2009, which was funded by AstraZeneca/Bristol-Myers Squibb Alliance and The Amylin-Lilly Alliance.

Program Overview: Type 2 diabetes is a significant and growing concern for primary care clinicians, with significant associated complications, including CVD, peripheral neuropathy, nephropathy, and blindness. Recognizing patients at significant risk for prediabetes will enable clinicians to prevent disease onset and development into full-blown diabetes. This activity offers a case-based approach to identifying risk factors and diagnosing and managing the patient with prediabetes. Learning Objectives: After completing this activity, the participant will be able to 1. Define prediabetes and monitor its development through the measurement of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) 2. Identify how ethnicity plays a role in CVD risk stratification Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of .75 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with possible prediabetes. Release Date: September 30, 2009 Expiration Date: September 30, 2010 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Atlanta, Georgia, on June 27, 2009, which was funded by AstraZeneca/Bristol-Myers Squibb Alliance and The Amylin-Lilly Alliance.

Program Overview: Allergic rhinitis and chronic idiopathic urticaria are histamine-induced conditions that have a substantial impact on patient health and quality of life. Allergic rhinitis, which affects more than 14% of adults in the US, can impact both work and school productivity and is associated with comorbidities including asthma, sinusitis, and sleep disorders. Chronic idiopathic urticaria affects 0.5% to 1.0% of the American population and is highly debilitating, negatively impacting sleep, mobility, and energy, as well as home, work, and social life. Although antihistamines are common first-line treatments for both conditions, significant barriers remain to successful outcomes. Allergic rhinitis is frequently underdiagnosed and undertreated, and chronic idiopathic urticaria is often managed inappropriately. Diagnostic Workup and Management of Histamine-induced Disorders: Allergic Rhinitis and Chronic Urticaria will provide primary care clinicians with up-to-date, evidence-based information on diagnosing and managing these chronic conditions. Learning Objectives: After completing this activity, the participant will be able to 1. Identify strategies to overcome barriers for adequate control of allergic rhinitis symptoms 2. Create treatment strategies to improve outcomes for patients with chronic idiopathic urticaria Accreditation/Designation Statement: Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. Target Audience: This activity is targeted to all physicians and other healthcare professionals who treat patients with allergic rhinitis or chronic urticaria. Release Date: October 21, 2009 Expiration Date: October 21, 2010 Medium: Podcast Acknowledgment of Commercial Support: This activity was developed from the live Best Practices in Primary Care™ program held in Atlanta, Georgia, on June 26, 2009, and is funded by sanofi-aventis US Inc. and UCB, Inc.